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PRIMARY CARE: THE ART AND SCIENCE OF ADVANCED PRACTICE
NURSING – 6TH EDITION EXAM 2026 QUESTIONS LATEST VERSION
QUESTIONS AND ANSWERS
Primary Care: The Art and Science of Advanced Practice Nursing – 6th Edition Exam
Bank
250 Questions with Detailed Rationales
Based on Dunphy, Winland-Brown, Porter & Thomas (6th Edition)
SECTION 1: FOUNDATIONS OF PRIMARY CARE – THE CIRCLE OF CARING
(Questions 1-25)
Question 1
A nurse practitioner has conducted a literature review on the effect of handwashing on
the incidence of hospital-acquired infections. An article presented findings at a level of
significance of <0.01. What does this indicate about the study results?
A) The control group and the experimental group were more than 99% similar
B) The findings have less than a 1% chance of being attributable to chance
C) The effects of the intervention were nearly zero
D) The clinical significance of the findings was less than 1:100
Answer: B
Rationale: The level of significance (<0.01) indicates there is less than a 1% probability that
the results are due to chance. This supports the statistical significance of the findings but does
not address clinical significance, which requires interpretation of the magnitude and practical
importance of the findings. A p-value of <0.01 suggests strong evidence against the null
hypothesis .
Question 2
A nurse practitioner has expressed skepticism to a colleague about the value of nursing
research, claiming that it has little relevance to practice. How can the colleague best
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defend the importance of nursing research?
A) The existence of nursing research means that nurses can now access federal grant money
B) Nursing research has allowed the development of master's and doctoral programs and
increased the credibility of the profession
C) The growth of nursing research has caused nursing to be viewed as a true profession rather
than as a trade
D) The application of nursing research has the potential to improve nursing practice and
patient outcomes
Answer: D
Rationale: The greatest value of nursing research lies in its potential to improve practice and,
ultimately, patient outcomes. This is the most compelling defense of its importance,
superseding contributions to education programs, grant funding, or public perception of the
profession .
Question 3
A nurse with a baccalaureate degree working in labor and delivery notices that many
new mothers abandon breastfeeding when they experience early challenges. Which role
is this nurse most likely to play in a research project testing an intervention to promote
breastfeeding?
A) Applying for grant funding
B) Posing the clinical problem to one or more nursing researchers
C) Planning the methodology of the research project
D) Carrying out the intervention and submitting results for publication
Answer: B
Rationale: A major role for staff-level nurses is to identify clinical questions or problems for
research. Grant applications, methodological planning, and publication submission are
normally carried out by nurses with advanced research degrees .
Question 4
The nurse practitioner understands that evidence-based practice (EBP) is best defined
as:
A) The use of clinical trials to guide all patient care decisions
B) The integration of best research evidence with clinical expertise and patient values
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C) Following established clinical practice guidelines without exception
D) The application of research findings from randomized controlled trials only
Answer: B
Rationale: Evidence-based practice is the integration of the best available research evidence,
clinical expertise, and patient preferences and values. This definition acknowledges that EBP
is not rigid protocol adherence but a dynamic process that incorporates multiple sources of
knowledge and patient individuality .
Question 5
A nurse practitioner is providing care in a community setting. Which action is most
likely to empower the client?
A) Encouraging the client to acknowledge their contribution to their current health state
B) Providing information that matches the client's expressed needs
C) Encouraging the client to involve family members in their care
D) Delegating care tasks to the client and reducing the frequency of visits
Answer: B
Rationale: Client empowerment is often fostered by assessing and meeting a client's
expressed need for information. While acknowledging contributions to health status and
involving family can be beneficial, providing information that directly addresses what the
client wants to know is most directly empowering .
Question 6
The nurse practitioner understands that the four basic principles of medical ethics
include:
A) Beneficence, nonmaleficence, autonomy, and justice
B) Fidelity, veracity, confidentiality, and advocacy
C) Caring, compassion, competence, and commitment
D) Respect, dignity, honesty, and fairness
Answer: A
Rationale: The four basic principles of medical ethics are beneficence (doing good),
nonmaleficence (avoiding harm), autonomy (respecting patient self-determination), and
justice (fair distribution of benefits and burdens). These principles provide a framework for
ethical decision-making in primary care .
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Question 7
An elderly female client who resides in the community tends to defer decisions
regarding her care to her eldest son. How should the NP respond to the client's
reluctance to make independent decisions?
A) Discuss this observation with the client and her son in an open manner and explore
alternatives
B) Organize care so that it takes place at times when the son is not present in the home
C) Accommodate this aspect of the client's family dynamics when planning and carrying out
care
D) Insist that the client make her own decisions
Answer: C
Rationale: The NP should respect the client's autonomy and accommodate family dynamics
when planning care. Deference to family members is culturally appropriate in many
traditions. The NP should address the situation directly with the client (and the son if she is
present) to see if this is her preference or if the son is exerting undue influence .
Question 8
A central aspect of the philosophy of community care is that:
A) The client is in charge of his or her health and healthcare in the community
B) Nurses maximize their scope of practice in noninstitutional settings
C) Community settings allow for the greatest number and variety of treatment options
D) The nurse becomes the key member of the healthcare team in a community setting
Answer: A
Rationale: A central premise of community healthcare is that patients/clients are in charge of
their own health and healthcare. The move toward community care is not motivated by an
increased role for nurses but by the philosophy of patient empowerment and self-
determination .
Question 9
A nurse practitioner is preparing to obtain informed consent for a research study.
Which action is most important?
A) Ensure the patient signs the consent form before any study procedures begin
B) Explain the study's purpose, risks, benefits, and alternatives in language the patient
understands
PRIMARY CARE: THE ART AND SCIENCE OF ADVANCED PRACTICE
NURSING – 6TH EDITION EXAM 2026 QUESTIONS LATEST VERSION
QUESTIONS AND ANSWERS
Primary Care: The Art and Science of Advanced Practice Nursing – 6th Edition Exam
Bank
250 Questions with Detailed Rationales
Based on Dunphy, Winland-Brown, Porter & Thomas (6th Edition)
SECTION 1: FOUNDATIONS OF PRIMARY CARE – THE CIRCLE OF CARING
(Questions 1-25)
Question 1
A nurse practitioner has conducted a literature review on the effect of handwashing on
the incidence of hospital-acquired infections. An article presented findings at a level of
significance of <0.01. What does this indicate about the study results?
A) The control group and the experimental group were more than 99% similar
B) The findings have less than a 1% chance of being attributable to chance
C) The effects of the intervention were nearly zero
D) The clinical significance of the findings was less than 1:100
Answer: B
Rationale: The level of significance (<0.01) indicates there is less than a 1% probability that
the results are due to chance. This supports the statistical significance of the findings but does
not address clinical significance, which requires interpretation of the magnitude and practical
importance of the findings. A p-value of <0.01 suggests strong evidence against the null
hypothesis .
Question 2
A nurse practitioner has expressed skepticism to a colleague about the value of nursing
research, claiming that it has little relevance to practice. How can the colleague best
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defend the importance of nursing research?
A) The existence of nursing research means that nurses can now access federal grant money
B) Nursing research has allowed the development of master's and doctoral programs and
increased the credibility of the profession
C) The growth of nursing research has caused nursing to be viewed as a true profession rather
than as a trade
D) The application of nursing research has the potential to improve nursing practice and
patient outcomes
Answer: D
Rationale: The greatest value of nursing research lies in its potential to improve practice and,
ultimately, patient outcomes. This is the most compelling defense of its importance,
superseding contributions to education programs, grant funding, or public perception of the
profession .
Question 3
A nurse with a baccalaureate degree working in labor and delivery notices that many
new mothers abandon breastfeeding when they experience early challenges. Which role
is this nurse most likely to play in a research project testing an intervention to promote
breastfeeding?
A) Applying for grant funding
B) Posing the clinical problem to one or more nursing researchers
C) Planning the methodology of the research project
D) Carrying out the intervention and submitting results for publication
Answer: B
Rationale: A major role for staff-level nurses is to identify clinical questions or problems for
research. Grant applications, methodological planning, and publication submission are
normally carried out by nurses with advanced research degrees .
Question 4
The nurse practitioner understands that evidence-based practice (EBP) is best defined
as:
A) The use of clinical trials to guide all patient care decisions
B) The integration of best research evidence with clinical expertise and patient values
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C) Following established clinical practice guidelines without exception
D) The application of research findings from randomized controlled trials only
Answer: B
Rationale: Evidence-based practice is the integration of the best available research evidence,
clinical expertise, and patient preferences and values. This definition acknowledges that EBP
is not rigid protocol adherence but a dynamic process that incorporates multiple sources of
knowledge and patient individuality .
Question 5
A nurse practitioner is providing care in a community setting. Which action is most
likely to empower the client?
A) Encouraging the client to acknowledge their contribution to their current health state
B) Providing information that matches the client's expressed needs
C) Encouraging the client to involve family members in their care
D) Delegating care tasks to the client and reducing the frequency of visits
Answer: B
Rationale: Client empowerment is often fostered by assessing and meeting a client's
expressed need for information. While acknowledging contributions to health status and
involving family can be beneficial, providing information that directly addresses what the
client wants to know is most directly empowering .
Question 6
The nurse practitioner understands that the four basic principles of medical ethics
include:
A) Beneficence, nonmaleficence, autonomy, and justice
B) Fidelity, veracity, confidentiality, and advocacy
C) Caring, compassion, competence, and commitment
D) Respect, dignity, honesty, and fairness
Answer: A
Rationale: The four basic principles of medical ethics are beneficence (doing good),
nonmaleficence (avoiding harm), autonomy (respecting patient self-determination), and
justice (fair distribution of benefits and burdens). These principles provide a framework for
ethical decision-making in primary care .
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Question 7
An elderly female client who resides in the community tends to defer decisions
regarding her care to her eldest son. How should the NP respond to the client's
reluctance to make independent decisions?
A) Discuss this observation with the client and her son in an open manner and explore
alternatives
B) Organize care so that it takes place at times when the son is not present in the home
C) Accommodate this aspect of the client's family dynamics when planning and carrying out
care
D) Insist that the client make her own decisions
Answer: C
Rationale: The NP should respect the client's autonomy and accommodate family dynamics
when planning care. Deference to family members is culturally appropriate in many
traditions. The NP should address the situation directly with the client (and the son if she is
present) to see if this is her preference or if the son is exerting undue influence .
Question 8
A central aspect of the philosophy of community care is that:
A) The client is in charge of his or her health and healthcare in the community
B) Nurses maximize their scope of practice in noninstitutional settings
C) Community settings allow for the greatest number and variety of treatment options
D) The nurse becomes the key member of the healthcare team in a community setting
Answer: A
Rationale: A central premise of community healthcare is that patients/clients are in charge of
their own health and healthcare. The move toward community care is not motivated by an
increased role for nurses but by the philosophy of patient empowerment and self-
determination .
Question 9
A nurse practitioner is preparing to obtain informed consent for a research study.
Which action is most important?
A) Ensure the patient signs the consent form before any study procedures begin
B) Explain the study's purpose, risks, benefits, and alternatives in language the patient
understands
